Human papillomavirus and survival of patients with oropharyngeal cancer (RTOG 0129)
Analysing a large chemoradiation trial showed that HPV-positive oropharyngeal cancers have a far better prognosis than HPV-negative ones, with three-year survival of 82 versus 57 percent, and that smoking history further modifies risk.
Overview
Retrospective analysis of 323 patients with stage III to IV oropharyngeal cancer treated with cisplatin chemoradiation in RTOG 0129, stratified by tumour HPV status determined by in situ hybridisation and p16 immunohistochemistry.
HPV-positive tumours (63.8 percent) had three-year overall survival of 82.4 versus 57.1 percent (hazard ratio for death 0.42 after adjustment), and a recursive partitioning model combining HPV status, pack-years of smoking, T stage and N stage defined low, intermediate and high-risk groups.
- Three-year overall survival 82.4 percent HPV-positive vs 57.1 percent HPV-negative.
- Smoking of more than 10 pack-years shifted HPV-positive patients into intermediate risk.
HPV-positive oropharyngeal cancer is now staged and studied separately, and this risk model underlies de-escalation trials and the eighth-edition staging system.
- Retrospective analysis of a single trial population treated with chemoradiation.
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